Chlorine VBIED attack in Ramadi

Spent the past few days travelling in-theatre. As we shut down the Navy shock/trauma in Al Asad to make way for the Army's Level III hospital, the ortho/trauma team put together some critical supplies in Al Asad for the Ramadi mission. The supplies were supposed to convoy to Ramadi, but a logistical SNAFU kept them in Al Asad. So I flew up to hand carry our gear back to Ramadi.
Trying to get around in-theatre is an inconsistent process. All part of the adventure. I have to send an assault support request (ASR) through Marine Corps. aviation and wait for the request to run up and back down the chain of command. My initial request was granted for Thursday night, but required a connecting helo flight in Taquaddum (TQ) . When I got to TQ, I re-manifested for the next flight and was told it left without me. The manifest personnel in TQ told me this happens on a nightly basis: flights arrive early to get a head start on their runs for the night, and will not wait for you if you haven't arrived yet. Essentially the response is: tough luck, find another mode of transportation. In theory, a confirmed ASR mission number is the same thing as a plane ticket; bird in hand so to speak. However, in practical application out here, anything goes. I ended up catching a C-130 in the morning instead. Of course, that meant spending the night on a cot on the flightline.....
Coming back was equally interesting. I apparently had not one, but two ASR mission numbers. So one of the helos was on the medical pad in Al Asad last night looking for me. They called Ramadi and told them I disappeared. I was on the flight line with all my gear manifested for another flight. This was despite the Army tactical commands at both Al Asad and Ramadi working together over a two day period to get me back. I travelled with two H-53 Helos loaded with Iraqi Army personnel deploying elsewhere in the Anbar Province.

This all brings me to the chlorine VBIED attack I missed Friday. The surgical team was in the middle of triaging and treating patients from a vehicle roll-over in the morning when the blast occurred. They said the blast was significant enough to shake the trauma bay, and they actually felt their clothes lift from the concussion. Within minutes, Bradleys, Strikers, and Humvees descended upon Charlie Medical with patients from every conceivable direction. The entire Army/Navy team worked over 14 hours straight to stabilize, treat, and transport the patients that lived. We were flying patients all over the theatre: Balad, Al Asad, Baghdad, ect. Reports vary, but Charlie Medical said 27 died, and over 40 were treated at our facility. Actual numbers (especially injured civilians) may be higher.
Chlorine VBIED attacks have become more commonplace (9 since January) in the Ramadi/Fallujia Sunni Triangle region. The first attack was January 28, also in Ramadi. The insurgents are reaching out in wider circles to spread panic among the general population. Chlorine is easily available and difficult to control. Although this is making sensational press, weaponizing chlorine is not especially effective. Generally, the heat will quickly neutralize chlorine vapor, and the vapor that survives the heat is not only a visible gas (greenish tint), but has a noxious smell. This makes it fairly easy to avoid, unlike some of the more deadly gases out there such as VX. Chlorine is also water-soluble and is easily irrigated. Having said that, some of the patients did require airway management related to the chlorine exposure. A large vapor level will liquefy alveoli (gas exchange pockets in the lungs) and can quickly cause death. As of now, we are working on ways to counter this threat in the future....and that's all I can say.

http://seattlepi.nwsource.com/national/1107AP_Iraq_Chlorine_Gas_Glance.html
http://www.allheadlinenews.com/articles/7006973707